Contact lens manufacturers and public relations experts in the industry have urged us for many years to write about ethics in Contact Lens Spectrum. We have generally avoided this issue because our reader surveys have repeatedly informed us that most of our readers were not interested. From time to time, we publish a letter from a reader about ethical issues.

A recent article in "Marketing to Physicians" by Joan Schuman outlines some of these ethical issues regarding marketing. Recently, the American Medical Association, the Pharmaceutical Research and Manufacturers of America and the Office of the Inspector General of the Department of Health and Human Services have published guidelines regarding marketing to health care professionals. These guidelines encourage manufacturers to provide scientific and educational materials and programs. They discourage unnecessary consulting, giving of expensive gifts and providing physicians and spouses with vacations. Clearly, they discourage quid pro quo: giving the practitioner something, cash, gifts, travel and other rewards, with an agreement to buy or prescribe specific products. AMA guidelines restrict gifts to only those that are educational and would benefit patients. They discourage cash and entertainment. Some companies, including at least one contact lens manufacturer, have policies that prohibit holding educational programs at resort locations. Continuing Medical Education guidelines require that educators disclose their relationships with sponsors. Even the provision of product samples is being called into question. Lance Plunkett, JD, counsel to the American Optometric Association, questioned the "foisting unnecessary or excessive or unwarranted treatments on patients."

What is acceptable?

Gifts related to work worth less than $100 with no quid pro quo

Textbooks and other educational materials

Meals that are not extravagant associated with real educational activity

Certainly, manufacturers who sponsor continuing education in their area of interest should provide a nonrestricted grant to the organization who is preparing the CE program or project. The organization will then be responsible for the speakers, the program content and paying the lecturers.

In the end, what we do in our offices and clinics should depend on what is in the patients' best interest and nothing more.